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Conclusion:
Guidelines for regional LN did not significantly
improve the consistency of contouring among ROs. The J-ROs
were the most accurate in contouring according to AIRO
guidelines and showed the highest level of homogeneity,
while the S-ROs followed the guidelines to a lesser extent,
probably because of higher self-confidence.
OC-0052
Long-term age dependent failure pattern after BCT vs.
mastectomy in low-risk breast cancer patients
T. Laurberg
1
Aarhus University Hospital, Department of Experimental
Clinical Oncology, Aarhus, Denmark
1
, C. Lyngholm
1
, J. Alsner
1
, P. Chritiansen
2
, J.
Overgaard
1
2
Aarhus University Hospital, Department of Surgery P- Breast
and Endocrine Section, Aarhus, Denmark
Purpose or Objective:
Optimal local treatment for young
women with early-stage breast cancer remains controversial
because of the lack of knowledge as to whether local
recurrence (LR) can be the site of metastatic disease. The
aim was to describe the age depending LR pattern as a
function of time (0-20 years) and local treatment, given as
either Breast conserving therapy (BCT) or mastectomy alone.
Furthermore to test, if LR was associated with an excess risk
of distant metastasis (DM) and translate into a higher
mortality after BCT.
Material and Methods:
1077 Danish patients were enrolled in
this population-based cohort study. The patients were
diagnosed in the period from 1989 to 1998, classified as low-
risk (lymph-node negative, tumor size <5 cm), treated with
mastectomy (N= 712) or BCT (N=364) and received no
systemic treatment. The cohort included all Danish low-risk
patients below 41 years (N = 305) and patients from one part
of Denmark. Patient identification, treatment, and 20-year
recurrence data were ascertained from the DBCG.
Results:
After 20 years the cum incidence of LR was 18 %
after BCT (N=66) and 6.7% after mastectomy (N=55). The LR
pattern of failure was different depending on age: young ( ≤45
year) vs. old (<45 year) and treatment: BCT vs. mastectomy.
The older mastectomy patients developed only very early LR
(< 5 year), young mastectomy patients developed early LR (0-
10 year), and BCTpatients despite age developed LR
throughout the 20-year period (Fig 1). Among young patients,
the BCT group had a higher risk of LR after 20 years
compared to the mastectomy, RD = 13% (4.8-20), and LR was
a prognostic marker for DM, HR =2.0 (1.3-3.1). The 20-year
mortality among the young patients was significantly higher
after BCT compared to mastectomy: Breast cancer death, HR
=1.6 (1.0-2.5) and Death, HR =1.7 (1.1-2.6). Among the older
patients, LR was not a prognostic marker for DM after 20
years, HR: 0.9 (0.3-2.2), and local treatment was not
associated with Breast cancer death, HR =0.8 (0.5-1.2).
Conclusion:
In the group of patients treated with
mastectomy all LR occured within the first 10 years. In
contrast, BCT patients developed LR throughout the period
and had a significantly higher cumulative incidence of LR at
20 years. Within the young patients LR was associated with
DM, and BCT was associated with a significantly higher
mortality. Among older patients LR was not a prognostic
marker for DM and there was no difference in Breast cancer
mortality between the two treatment groups.
OC-0053
Re- irradiation for locally recurrent breast cancer
E. Bräutigam
1
Krankenhaus der Barmherzigen Schwestern - Linz, Radiation
Oncology, Linz, Austria
1
, C. Track
1
, M. Geier
1
, H. Geinitz
1
Purpose or Objective:
To report an analysis of treatment
outcomes and toxicity of a cohort of patients re- irradiated
after a second breast conserving surgery or no further
surgery.
Material and Methods:
Between 11/05 and 10/15, 32 women
were re- irradiated with 50- 60 Gy for locally recurrent breast
cancer. The first RT course included postoperative
radiotherapy with a total dose of 50 Gy in 25 or 50,4Gy in 28
fractions followed by a boost dose to the tumor bed
according to risk factors in 81.3%. In 18.7% supraclavicular
nodes were treated with 50Gy.The median age at first
diagnosis was 53.3 years (range 36- 69.7). 78.1% of the
women were postmenopausal. 81.25% of the tumors were
pathologically classified as T1, 12.5% as T2 and 6.25% as